[Federal Register Volume 86, Number 51 (Thursday, March 18, 2021)]
[Rules and Regulations]
[Pages 14690-14693]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-05548]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 400, 410, 414, 415, 423, 424, and 425

[CMS-1734-F, CMS-1734-IFC, CMS-1744-F, CMS-5531-F and CMS-3401-IFC] CN
RIN 0938-AU10, 0938-AU31, 0938-AU32, and 0938-AU33


Medicare Program; CY 2021 Payment Policies Under the Physician 
Fee Schedule and Other Changes to Part B Payment Policies; Medicare 
Shared Savings Program Requirements; Medicaid Promoting 
Interoperability Program Requirements for Eligible Professionals; 
Quality Payment Program; Coverage of Opioid Use Disorder Services 
Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid 
Treatment Programs; Electronic Prescribing for Controlled Substances 
for a Covered Part D Drug; Payment for Office/Outpatient Evaluation and 
Management Services; Hospital IQR Program; Establish New Code 
Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model 
Emergency Policy; Coding and Payment for Virtual Check-In Services 
Interim Final Rule Policy; Coding and Payment for Personal Protective 
Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in 
Response to the Public Health Emergency (PHE) for COVID-19; and 
Finalization of Certain Provisions From the March 31st, May 8th and 
September 2nd Interim Final Rules in Response to the PHE for COVID-19; 
Correction

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Final rule and interim final rule; correction.

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SUMMARY: This document corrects technical errors in the final rule that 
appeared in the December 28, 2020, Federal Register entitled, 
``Medicare Program; CY 2021 Payment Policies under the Physician Fee 
Schedule and Other Changes to Part B Payment Policies; Medicare Shared 
Savings Program Requirements; Medicaid Promoting Interoperability 
Program Requirements for Eligible Professionals; Quality Payment 
Program; Coverage of Opioid Use Disorder Services Furnished by Opioid 
Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; 
Electronic

[[Page 14691]]

Prescribing for Controlled Substances for a Covered Part D Drug; 
Payment for Office/Outpatient Evaluation and Management Services; 
Hospital IQR Program; Establish New Code Categories; Medicare Diabetes 
Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and 
Payment for Virtual Check-in Services Interim Final Rule Policy; Coding 
and Payment for Personal Protective Equipment (PPE) Interim Final Rule 
Policy; Regulatory Revisions in Response to the Public Health Emergency 
(PHE) for COVID-19; and Finalization of Certain Provisions from the 
March 31st, May 8th and September 2nd Interim Final Rules in Response 
to the PHE for COVID-19'' (hereinafter referred to as the CY 2021 PFS 
final rule).

DATES: This correction is effective March 18, 2021, and is applicable 
beginning January 1, 2021.

FOR FURTHER INFORMATION CONTACT: Terri Plumb, (410) 786-4481, Gaysha 
Brooks, (410) 786-9649, or Annette Brewer (410) 786-6580.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2020-26815 of December 28, 2020, the CY 2021 PFS final 
rule (85 FR 84472), there were technical errors that are identified and 
corrected in this correcting document. These corrections are effective 
and applicable beginning January 1, 2021.

II. Summary of Errors

A. Summary of Errors in the Preamble

    On page 84503, in the Medicare telehealth services list, due to a 
typographical error, the CPT code is incorrect.
    On page 84513 in Table 14: Final Services for Temporary Addition to 
the Medicare Telehealth Services List, we inadvertently included CPT 
code 96121.
    On page 84516 in Table 14: Final Services for Temporary Addition to 
the Medicare Telehealth Services List, we inadvertently included CPT 
codes 99221, 99222, and 99223.
    On page 84560 in Table 23: CY 2020 Work RVUs and CY 2021 Final Work 
RVUs, we inadvertently included CPT codes 99492 and 99493 and 
inadvertently omitted HCPCS codes G2211 and G2212. There were no 
changes made to the work RVUs for CPT codes 99492 and 99493 in this 
final rule.
    On page 84562 in Table 24: Comparison of Physician Time, and 
Clinical Staff Time (Non-facility and Facility) for HCPCS Codes, CY 
2020 Values vs. 2021 Final Values, we inadvertently included CPT codes 
99492 and 99493 and inadvertently omitted HCPCS Codes G2211 and G2212.
    On page 84665 in Table 28: CY 2021 Work RVUs for New, Revised and 
Potentially Misvalued Codes, due to a typographical error, we 
inadvertently included the incorrect descriptor for HCPCS code G2216.

B. Summary and Correction of Errors in the Addenda on the CMS Website

    Due to a technical change that was applied in error to the indirect 
practice expense (PE) allocation for HCPCS codes G2082 and G2083 in the 
final rule, the Addendum B posted on the CMS website contained errors 
for the Non-Facility PE RVUs, Facility PE RVUs, Total Non-Facility 
RVUs, and the Total Facility RVUs. Specifically, we assigned an 
incorrect physician specialty in our ratesetting process to the 
predecessor codes for HCPCS codes G2082 and G2083 in the CY 2020 PFS 
final rule and CY 2021 PFS proposed rule. We intended to correct the 
assigned physician specialty for these codes in the CY 2021 PFS final 
rule; however, we neglected to discuss this correction in the course of 
PFS rulemaking for CY 2021. Since this technical change was applied in 
the CY 2021 PFS final rule, but was not discussed in the course of PFS 
rulemaking for CY 2021, we are removing this change for the 2021 
calendar year, retroactive to January 1, 2021. The Non-Facility PE 
RVUs, Facility PE RVUs, Total Non-Facility RVUs, and Total Facility 
RVUs that resulted from the correction of this error are reflected in 
the revised CY 2021 Addendum B available on the CMS website at https://www.cms.gov/medicaremedicare-fee-service-paymentphysicianfeeschedpfs-federal-regulation-notices/cms-1734-f. Specifically, we are correcting 
the following:
    1. In Addendum B--Relative Value Units and Related Information Used 
in the CY 2021 PFS final rule, line 12615 for CPT/HCPCS code G2082, 
Visit esketamine 56m or less,
    a. Seventh column, the Non-Facility PE RVUs the value ``17.68'' is 
corrected to read ``24.06''.
    b. Eighth column, the Facility PE RVUs the value '' 0.17'' is 
corrected to read ``0.27''.
    c. Tenth column, Total Non-Facility RVUs the value ``18.43'' is 
corrected to read ``24.81''.
    d. Eleventh column, Total Facility RVUs the value ``0.92'' is 
corrected to read ``1.02''.
    2. In Addendum B--Relative Value Units and Related Information Used 
in the CY 2021 PFS final rule, line 12616 for CPT/HCPCS G2083 for Visit 
esketamine, >56m,
    a. Seventh column the Non-Facility PE RVUs the value ``25.54'' is 
corrected to read ``34.72''.
    b. Eighth column the Facility PE RVUs the value ``0.17'' is 
corrected to read ``0.27''.
    c. Tenth column, Total Non-Facility RVUs the value ``26.29'' is 
corrected to read ``35.47''.
    d. Eleventh column Total Facility RVUs the value ``0.92'' is 
corrected to read ``1.02''.

III. Waiver of Proposed Rulemaking and Delay in Effective Date

    Under 5 U.S.C. 553(b) of the Administrative Procedure Act (the 
APA), the agency is required to publish a notice of the proposed rule 
in the Federal Register before the provisions of a rule take effect. 
Similarly, section 1871(b)(1) of the Social Security Act (the Act) 
requires the Secretary to provide for notice of the proposed rule in 
the Federal Register and provide a period of not less than 60 days for 
public comment. In addition, section 553(d) of the APA and section 
1871(e)(1)(B)(i) of the Act mandate a 30-day delay in effective date 
after issuance or publication of a rule. Sections 553(b)(B) and 
553(d)(3) of the APA provide for exceptions from the APA notice and 
comment, and delay in effective date requirements; in cases in which 
these exceptions apply, sections 1871(b)(2)(C) and 1871(e)(1)(B)(ii) of 
the Act provide exceptions from the notice and 60-day comment period 
and delay in effective date requirements of the Act as well. Section 
553(b)(B) of the APA and section 1871(b)(2)(C) of the Act authorize an 
agency to dispense with normal notice and comment rulemaking procedures 
for good cause if the agency makes a finding that the notice and 
comment process is impracticable, unnecessary, or contrary to the 
public interest, and includes a statement of the finding and the 
reasons for it in the rule. In addition, section 553(d)(3) of the APA 
and section 1871(e)(1)(B)(ii) allow the agency to avoid the 30-day 
delay in effective date where such delay is contrary to the public 
interest and the agency includes in the rule a statement of the finding 
and the reasons for it.
    In our view, this correcting document does not constitute a 
rulemaking that would be subject to these requirements. This document 
merely corrects technical errors in the CY 2021 PFS final rule. The 
corrections contained in this document are consistent with, and

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do not make substantive changes to, the policies and payment 
methodologies that were proposed, subject to notice and comment 
procedures, and adopted in the CY 2021 PFS final rule. As a result, the 
corrections made through this correcting document are intended to 
resolve inadvertent errors so that the CY 2021 PFS final rule 
accurately reflects the policies adopted in the final rule. Even if 
this were a rulemaking to which the notice and comment and delayed 
effective date requirements applied, we find that there is good cause 
to waive such requirements. Undertaking further notice and comment 
procedures to incorporate the corrections in this document into the CY 
2021 PFS final rule or delaying the effective date of the corrections 
would be contrary to the public interest because it is in the public 
interest to ensure that the rule accurately reflects our policies as of 
the date they take effect. Further, such procedures would be 
unnecessary because we are not making any substantive revisions to the 
final rule, but rather, we are simply correcting the Federal Register 
document to reflect the policies that we previously proposed, received 
public comment on, and subsequently finalized in the CY 2021 PFS final 
rule. For these reasons, we believe there is good cause to waive the 
requirements for notice and comment and delay in effective date.

IV. Correction of Errors

    In FR Doc. 2020-26815 (85 FR 84472), published December 28, 2020, 
make the following corrections:

A. Correction of Errors in the Preamble

    1. On page 84503, second column, third bullet, third line, the 
number ``994780'' is corrected to read ``99478''.
    2. On page 84513 in Table 14: Final Services for Temporary Addition 
to the Medicare Telehealth Services List, the second column, the third 
row, is corrected by removing the listing for HCPCS code 96121 in the 
second and third columns.
    3. On page 84516 in Table 14: Final Services for Temporary Addition 
to the Medicare Telehealth Services List, the second column, the 
second, third, and fourth rows are corrected by removing the listings 
for HCPCS codes 99221, 99222, and 99223 in the second and third 
columns.
    4. On page 84560, Table 23: CY 2020 Work RVUs and CY 2021 Final 
Work RVUs, is corrected by removing CPT codes 99492 and 99493 and 
adding rows for HCPCS codes G2211 and G2212 to read as follows:

----------------------------------------------------------------------------------------------------------------
                                                                                   CY 2020 work    Final CY 2021
               HCPCS code                            Long descriptor                   RVUs          work RVUs
----------------------------------------------------------------------------------------------------------------
G2211..................................  Visit complexity inherent to evaluation             N/A            0.33
                                          and management associated with medical
                                          care services that serve as the
                                          continuing focal point for all needed
                                          health care services and/or with
                                          medical care services that are part of
                                          ongoing care related to a patient's
                                          single, serious condition or a complex
                                          condition. (Add-on code, list
                                          separately in addition to office/
                                          outpatient evaluation and management
                                          visit, new or established).
G2212..................................  Prolonged office or other outpatient                N/A            0.61
                                          evaluation and management service(s)
                                          beyond the maximum required time of
                                          the primary procedure which has been
                                          selected using total time on the date
                                          of the primary service; each
                                          additional 15 minutes by the physician
                                          or qualified healthcare professional,
                                          with or without direct patient contact
                                          (List separately in addition to CPT
                                          codes 99205, 99215 for office or other
                                          outpatient evaluation and management
                                          services). (Do not report G2212 on the
                                          same date of service as 99354, 99355,
                                          99358, 99359, 99415, 99416). (Do not
                                          report G2212 for any time unit less
                                          than 15 minutes).
----------------------------------------------------------------------------------------------------------------

    5. On page 84562, Table 24: Comparison of Physician Time, and 
Clinical Staff Time (Non-facility and Facility) for HCPCS Codes, CY 
2020 Values vs. 2021 Final Values, is corrected by removing CPT codes 
99492 and 99493 and adding rows for HCPCS codes G2211 and G2212 to read 
as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                            NF clinical     NF clinical    Fac. clinical   Fac. clinical
                                                            Phys. time      Phys. time      staff time      staff time      staff time      staff time
                          HCPCS                           (minutes)-- CY  (minutes)-- CY  (minutes)-- CY  (minutes)-- CY  (minutes)-- CY  (minutes)-- CY
                                                               2020         2021 final         2020         2021 final         2020         2021 final
--------------------------------------------------------------------------------------------------------------------------------------------------------
G2211...................................................              11              11               0               0               0               0
G2212...................................................              15              15               2               2               0               0
--------------------------------------------------------------------------------------------------------------------------------------------------------


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    6. On page 84665 in Table 28: CY 2021 Work RVUs for New, Revised 
and Potentially Misvalued Codes, the second column, the third row, the 
phrase ``Take-home supply of auto-injector naloxone'' is corrected to 
read ``Take-home supply of injectable naloxone''.

    Dated: March 12, 2021.
Wilma M. Robinson,
Deputy Executive Secretary to the Department, Department of Health and 
Human Services.
[FR Doc. 2021-05548 Filed 3-16-21; 8:45 am]
BILLING CODE 4120-01-P